TINEA PEDIA (Picture)

FOOT

The human foot has 26 bones, 33 joints, and more than 100 tendons, muscles, and ligaments. With such a complex structure, a lot can go wrong. While some foot problems are inherited, many occur because of years of wear and tear.

Signs of foot trouble include pain, excessively dry skin, thickened or discolored nails, swelling, redness, and unusual sensations. "Consumers should know that these symptoms are not normal," says Joshua Kaye, D.P.M, a podiatrist in Los Angeles. "Whatever the problem is, don't bury it in your shoe and hope it will go away."

Pain in the feet can trigger pain in the legs, hips, and back. Some foot problems can even signal a larger disease, which is why the American Podiatric Medical Association (APMA) suggests that people take their socks off when they go to their primary care physician for a regular checkup. In a recent APMA survey of more than 600 people, 73 percent said their feet were not routinely inspected at doctor visits.

Toenails that are rounded inward instead of outward could signal iron deficiency anemia. Kidney disease, heart disease, high blood pressure, and circulatory problems can cause the feet to swell. Tingling or numbness in the feet and slow-healing wounds could be signs of diabetes or other serious diseases, according to the APMA. Chronic stiffness in the toes could be a sign of arthritis.

"Changes in the structural appearance of the foot can also be signs of abnormalities such as tendon rupture, rheumatoid or osteoarthritis, or neuropathic disease," says Barbara Buch, M.D., acting clinical deputy director of the Food and Drug Administration's Division of General, Neurological and Restorative Devices.

Diabetes and the Feet

According to the American Diabetes Association, about 20 million people in the United States have diabetes, a disease in which the body does not produce or properly use insulin. But while nearly 15 million have been diagnosed with diabetes, another 6 million people are unaware that they have it.

"A problem that seems minor for many people, like a fungal infection or sores on the feet, can become catastrophic in someone with diabetes or other circulatory problems," says Jonathan Wilkin, M.D., former director of the FDA's Division of Dermatologic and Dental Drug Products. Diabetes is the leading cause of non-traumatic foot amputations each year.

People with diabetes may experience neuropathy in the feet, a condition that affects the nerves and the ability to feel pain and heat or cold. "Someone without sensation in the feet can literally step on a nail and not know it," says Amir Assili, D.P.M, a podiatrist in Gaithersburg, Md. Assili says a 28-year-old man who came in complaining of a loss of sensation in both feet was diagnosed with diabetes soon after.

Another major foot problem linked to diabetes is poor blood circulation. High levels of blood sugar damage the blood vessels, making them less able to supply the skin and other parts of the body with blood. Poor circulation interferes with the ability to heal and raises the risk of infection. Minor cuts or even cracks from dry skin can turn into ulcers, small red sores that can become deep and infected. Foot amputations may be necessary when an infection reaches bone and spreads beyond a manageable extent.Doctors normally treat diabetic foot ulcers by cleaning them and applying wound dressings, or with surgical debridement, which removes contaminated tissue from a wound to prevent infection. In severe cases, reconstructive procedures that reshape the foot may be needed to prevent undue pressure on the foot.

During the past few years, the FDA has approved new products to treat chronic foot ulcers that are not responding to standard methods. Examples are Apligraf, made by Organogenesis Inc. of Canton, Mass., and Dermagraft, made by Smith and Nephew in La Jolla, Calif.

"The optimal approach," Assili says, "is to prevent ulcers from occurring through tight blood sugar control and regular visits to an endocrinologist." People with diabetes should also see a podiatric physician at least once a year and practice the basics of good foot care that apply to everyone--wearing comfortable socks and shoes and maintaining foot hygiene. Those who have been diagnosed with decreased circulation or neuropathy with loss of protective sensation should be seen by their podiatric physician more frequently.

Feet should also be checked daily by the patient or family members for any cuts and sores. "Early detection is important because a problem can quickly turn serious," Assili says. People with diabetes and other circulatory problems should never try to treat their own feet, because of the risk of infection.

Shoes Make a Difference

As stylish as they may be, high heels and shoes that squeeze the feet are linked to a host of foot problems. Painful bunions, which are misaligned toe joints, are much more common in women than men. Poorly fitting shoes don't cause bunions, but can aggravate existing ones.

Some people with bunions can eliminate pain with conservative approaches such as wearing bunion pads, avoiding high heels, and buying comfortable shoes that are shaped like their feet and that provide more toe room.

Other common problems from tight shoes include nerve growths called neuromas, corns, calluses, blisters, and hammertoes, a condition in which the toes are bent like a claw.

"Shoes should be comfortable right when you buy them," says Jane Andersen, D.P.M., a podiatrist in Chapel Hill, N.C. "You should be able to wiggle your toes. And shoes should have a strong sole that flexes at the ball of your foot."

Consumers also should make sure that they're wearing the right size. "Most adults don't have their feet measured when they buy new shoes," Andersen says, "but your shoe size can change as you get older because the feet can spread and lengthen."

Buch says one way to ensure that you get the right shoe size is to stand on a blank piece of paper and trace the outline of your feet on the paper with a pen at home. "Your shoe choice should completely cover the outline of your foot," Buch says, "with no lines showing outside the shoe when the shoe is placed on top of the outline you traced."

Foot Hygiene

The foot has more than 250,000 sweat glands. It's the mixture of sweat and bacteria in our shoes and socks that makes feet smelly. "Clean, dry feet can lower the risk of both foot odor and fungus infections," says Kaye.

Feet should be washed every day with soap and lukewarm water, especially between the toes, and then dried completely with a soft towel. Any mild soap or antibacterial hand soap works fine.

"People spend a lot of time shampooing and conditioning their hair and applying soaps and lotions to their body, but then probably don't spend 10 seconds washing their feet," Kaye says. "Washing the feet with a wash cloth or similarly abrasive product is important because it helps remove the dead skin, bacteria, and fungus." For patients who can't reach their feet during a shower because of obesity, arthritis, or instability, Kaye recommends using a long-handle brush like a shower back brush.

People who want to soak their feet should use warm, soapy water, Kaye says. "Soaking feet in Epsom salt can cause excessive drying of skin," he says. "This is an important consideration for diabetics or with those who have existing dry or fragile skin. Consider soaking feet in warm water with a small amount of liquid dishwashing solution that has skin softeners. There is no benefit in soaking feet in Epsom salt compared to regular table salt."

Some people tell Kaye they soaked their feet in very hot water because they were trying to kill bacteria. He says, "Unfortunately, that type of home treatment often results in skin burns. If someone is diabetic or has poor circulation, hot water bottles or heating pads also shouldn't be used on the feet."

Applying moisturizing lotion on the feet after bathing can alleviate dry skin. "During dry winter months, apply a small amount of lotion a few times per day," Kaye says. "Inexpensive generic creams are usually equally effective as expensive brand-name products."

Kaye estimates that half of the ingrown toenails he treats are due to improper nail clipping. "Toenails should be trimmed straight across and not too short," he says. "Many people incorrectly cut the corners, leaving a small point of nail that then grows into the skin or they accidentally cut the skin."

People who pamper themselves with a salon pedicure also need to make sure that proper cutting and safety measures are followed. In the last few years, there have been reports of infections linked to nail salon whirlpool footbaths that hadn't been properly cleaned or disinfected.

Andersen suggests that people check to see that salons and their employees are licensed. "You could ask how they clean their tubs and instruments and how often," she says. "Some people bring their own instruments." People with diabetes should exercise caution when having salon treatments, and may be advised by their physicians to avoid treatments by anyone other than a trained podiatric or medical specialist.

Exercise Right

Wearing inadequate and worn-out shoes is a common mistake for athletes, says James Losito, D.P.M., team podiatrist for the Miami Heat basketball team and professor of podiatric biomechanics at Barry University in Miami Shores, Fla.

"Running shoes should be discarded after 200 miles to 400 miles of use and they should fit correctly," Losito says. "There should be a thumb-width of length between the longest toe and the end of a shoe. Failure to wear the correct shoe size can result in runner's toe, calluses, ingrown nails, fungal nail infections, and hammertoe deformities."

People also should purchase the right shoe for the sport. "Many injuries occur because someone is wearing a running shoe while playing basketball," Losito says.

Another common cause of athletic injuries is doing too much too soon. "Both overuse training habits and worn-out shoes could result in stress fractures, heel pain or heel spur (plantar fasciitis) or shin splints," he says. "It is important to start out slowly and increase distance, duration, and pace gradually. For runners, I recommend no more than a 10 percent increase per week."

Walking or jumping on hard surfaces and failing to stretch and do warm-ups may also cause shin splints, plantar fasciitis, and heel spurs. Losito says, "There is no solid evidence to confirm that stretching actually decreases the likelihood of injuries, but it makes sense to maintain flexibility through gentle stretching, especially following exercise."

According to the American Academy of Podiatric Sports Medicine, the most common pain associated with jogging is runner's knee, which can be caused by rolling in or down on the foot. With aerobics, rising on the toes can cause an inflamed Achilles tendon. Stress fractures can be caused by running and other repetitive strain. Sharp pain, bruising, or swelling after a foot injury warrants medical attention. Contrary to popular belief, it's possible to walk, even if a foot bone is broken.

Orthotic Devices

Orthotic devices are intended to make the feet more comfortable, minimize stress on the foot, or improve an abnormal or irregular walking pattern. An orthotic device could be a conservative approach to a foot problem, a preventive measure to avoid problems, or a useful support after foot surgery.

According to the American Academy of Orthopaedic Surgeons, orthotic devices commonly used include bunion shield pads, arch pads for people with a flat foot, and heel inserts for people with plantar fasciitis. These devices are sold over-the-counter (OTC) at drugstores and sporting stores. They can be custom made and also sold by podiatrists, physical therapists, or orthotic companies.

Consumers might do well to try a less expensive OTC orthotic device first. "But if the problem doesn't go away after six weeks, you may need to seek a professional consultation and a custom orthotic may be indicated," says Eddy Gosschalk of Southern California Orthotics and Prosthetics. "People who are at risk for developing wounds or who have an unusual foot shape tend to need a custom orthotic." To create a custom orthotic, a plaster cast is taken of your foot and sent to a laboratory.

Most orthotic devices are considered "Class I exempt" by the FDA. This category means they are exempt from pre-market notification requirements. But they still must be manufactured under a quality assurance program, be suitable for intended use, be adequately packaged and properly labeled, and have establishment registration and device-listing forms on file with the FDA. Legally marketed Class I devices are subject to the least regulatory control because they present minimal potential for harm to the user. But when orthotic devices make a new health claim or a claim for certain treatments, or use a fundamentally different technology, they must go through FDA clearance.

Non-Prescription Drug Products

The types of OTC products for foot health include pain medicines such as nonsteroidal anti-inflammatory drugs and products that treat athlete's foot, corns, calluses, blisters, and warts.

Depending on the intended use, some OTC foot products, such as lotions for moisturizing the skin, are considered cosmetics and not drugs. There are medicated powders and creams to treat athlete's foot. For corns and calluses, there are nonmedicated pads to improve comfort when walking, as well as medicated pads and patches that work to get rid of dead skin. Similar products are used to shrink warts. These products are typically made of salicyclic acid. They should be used with care so that healthy skin isn't harmed, and they should never be used by people with diabetes or poor foot circulation.

Matthew Holman, Ph.D., a scientist in the FDA's Office of Nonprescription Products, says consumers need to pay close attention to drug labels. "Consumers should read the indications, directions, and warnings carefully," Holman says. "A product won't be effective if you are trying to treat a condition that's not in the label. If it says to only use the product on intact skin with no open sores, that's important. If a product isn't working or the condition becomes worse, you need to seek a doctor's advice." People with heart disease, diabetes, and circulation problems should never self-treat because of the risk of infection.

Prescription Drugs

Prescription drugs for treating the feet include pain medicine, antibiotics for infections, and antifungal medicine. For instance, an ingrown toenail may require antibiotic or antifungal treatment if it becomes infected. For bunions and hammertoes, a cortisone injection may be given to relieve inflammation and pain.

Fungal nails make toenails thick, brittle, and discolored to white, yellow, or brown. The fungus grows deep in the nail bed, and it won't go away on its own. It also can spread to other toenails. "Discolored nails aren't always from fungus," says Andersen. "They could also be from trauma due to exercise or psoriasis, so we take a fungal culture to make a diagnosis."

Penlac (ciclopirox), made by Dermik Laboratories of Berwyn, Pa., is an example of a topical antifungal. It is generally used daily for several months for mild to moderate nail fungus. Side effects include irritation and redness around the nails. Oral medications for fungal infections, including fungal nails and athlete's foot, are Lamisil (terbinafine) made by Novartis Pharmaceuticals of East Hanover, N.J., and Sporanox (itraconazole), made by Janssen Pharmaceuticals of Titusville, N.J. These medicines travel through the bloodstream to attack the fungus. The tablets are taken daily for about 12 weeks. It takes about nine months for a healthy nail to grow in.

The most commonly reported side effects of the oral antifungals are headaches and stomachaches. In 2001, the FDA put out a public health advisory about both drugs and announced labeling changes. Both drugs have been associated with serious liver problems resulting in liver failure and death in rare cases. The FDA and the maker of Sporanox also warned against using Sporanox for those who have a heart condition, because of safety concerns.

Patients using these drugs should immediately report symptoms of persistent nausea, anorexia, fatigue, or vomiting, upper right abdominal pain or jaundice, dark urine, or pale stools. A simple blood test is used to check liver function during treatment.

Foot Surgery and Other Procedures

Common types of foot surgery include surgery to correct bunions, surgery for fungal nails when medications don't work, and surgery to reduce arthritis pain. For people who have chronic ingrown toenails, a procedure called matrixectomy may be used to prevent recurring problems. Andersen says, "We numb the toe and remove the smallest amount of the nail on the side, usually about one-eighth of an inch, and then use a chemical to kill the root or remove the root of the nail surgically."

Sometimes, bunions can be treated without surgery, but when bunions limit or affect one's daily activities, bunion surgery may be appropriate. Pain is the big factor here. Kaye says, "Bunion surgery may also be warranted if there is chronic inflammation and the person gets no relief from nonsteroidal anti-inflammatory drugs and other conservative treatments."

Kaye says there are two main components to bunion problems. "One problem is the pain associated with shoe pressure against the bony enlargement," he says. "The second condition is a stiff toe joint that causes internal joint pain during movement of the big toe. Both or either of these problems can occur."

Advanced surgical techniques have improved outcomes for bunion surgery. The type of surgery needed depends on the patient's age, activity level, and degree of deformity. Kaye says he doesn't only remove the "bump of bone," which won't usually produce lasting results. "We realign the bone and use a surgical screw for stable bone alignment," he says. Recovery time usually takes about four weeks.

"The precision in which the bone is cut, shaped, and realigned is critical," Kaye says. Though consumers may see lasers publicized to treat bunions, lasers can't cut bone or correct bunions, he says. Lasers are not cleared by the FDA for these indications.

According to the American College of Foot and Ankle Surgeons, there have also been advances in less invasive foot and ankle surgery. Newer surgical plates and screws let surgeons repair fractures with less trauma. Smaller incisions mean less bleeding and tissue damage.

In ankle arthroscopy, surgeons look at the ankle joint with a fiber optic camera system. This technique has been applied to knee surgery for several years, but now it's being used for bones and joints in the foot and ankle. This type of surgery can relieve inflammation from arthritis and ligament damage, with reduced recovery time as compared to open surgical procedures.

Before considering any surgery, people should always explore and discuss the nonsurgical options with their doctor, and the benefits and risks of surgery. It is also important to consider the doctor's experience and results with the procedure.

The American Orthopaedic Foot & Ankle Society (AOFAS) has released statements warning about trends in cosmetic surgery to improve the appearance of the foot. "Some women are getting surgeries to shorten toes and narrow their feet so they can fit into fashionable shoes," says Sharon Dreeben, M.D., chairwoman of the AOFAS Public Education Committee and an orthopedic surgeon in La Jolla, Calif.

"A woman recently called asking if I would inject collagen into her heel, and she will probably go doctor shopping to find someone who will do it," Dreeben says. "Some people want more padding to have cushion for high heels. But cosmetic foot surgery can result in chronic pain, infection, and nerve injury."

Dreeben has had to fix problems from cosmetic foot surgery that went wrong. "One woman had bunion surgery even though she hadn't been experiencing pain," she says. "She ended up with more problems, including nerve pain and difficulty walking."

The AOFAS defines cosmetic foot surgery as surgery that is aimed at only improving appearance. Dreeben says, "Foot surgery should only be used if the goal is to provide pain relief, improve function, or enhance quality of life during normal activities of daily living."

"I tell people: One difference between cosmetic surgery on the face and cosmetic surgery on the feet is that you don't walk around on your face. When you readjust one piece in the foot, it can affect everything."

(taken from www.fda.gov)

Chronically Sleep Deprived? You Can't Make Up For Lost Sleep

We've all experienced that occasional all-too-short night of sleep -- staying out too late at a party on a weeknight, studying into the wee hours for a morning exam or being kept up during the night with a sick child. Our bodies try to catch up by making us sleep more and/or more deeply the following night.

Very little is known about the health consequences of chronic partial sleep loss -- losing a little bit of sleep over a period of days, months or even years. (Credit: iStockphoto/Sharon Dominick)
It is well established that following an acute period of sleep loss, the body responds this way in order to maintain a homeostatic balance between sleep and wakefulness. Very little is known, however, about the health consequences of chronic partial sleep loss -- losing a little bit of sleep over a period of days, months or even years.
Now sleep researchers at Northwestern University have discovered that when animals are partially sleep deprived over consecutive days they no longer attempt to catch up on sleep, despite an accumulating sleep deficit. Their study is the first to show that repeated partial sleep loss negatively affects an animal's ability to compensate for lost sleep. The body responds differently to chronic sleep loss than it does to acute sleep loss.
The results, which shed light on a problem prevalent in industrialized nations with 24/7 societies such as the United States, where Americans get nearly an hour less sleep a night than they did 40 years ago, were published online recently by the Proceedings of the National Academy of Sciences (PNAS).
"We now know that chronic lack of sleep has an effect on how an animal sleeps," said Fred W. Turek, professor of neurobiology and physiology and director of Northwestern's Center for Sleep and Circadian Biology and an author of the paper. "The animals are getting by on less sleep but they do not try and catch up. The ability to compensate for lost sleep is itself lost, which is damaging both physically and mentally."
In the study, the researchers kept animals awake for 20 hours per day followed by a four-hour sleep opportunity, over five consecutive days. The team monitored brain wave and muscle activity patterns in order to precisely quantify sleep-wake patterns.
After the first day of sleep loss, animals compensated by increasing their intensity, or depth, of sleep, which is indicative of a homeostatic response. However, on the subsequent days of sleep loss, the animals failed to generate this compensatory response and did not sleep any more deeply or any longer than they did under non-sleep deprived conditions (baseline measurements). At the end of the study, the animals were given three full days to sleep as much as they wanted. Amazingly, they recovered virtually none of the sleep that was lost during the five-day sleep deprivation period.
The findings support what other scientists have discovered in recent experimental studies in humans. Chronic partial sleep loss of even two to three hours per night was found to have detrimental effects on the body, leading to impairments in cognitive performance, as well as cardiovascular, immune and endocrine functions. Sleep-restricted people also reported not feeling sleepy even though their performance on tasks declined.
The Northwestern team's results suggest that animals may undergo a change in their need for sleep, or in their sleep homeostat, in situations where normal sleep time is prohibited or where sleep could be detrimental for survival. An extreme but realistic example of this, says Turek, would be how animals respond to catastrophic environmental conditions, such as Hurricane Katrina. No matter how sleep deprived an animal or human may be, it would not be adaptive for the sleep homeostat to kick in and to make the animal fall sleep when it is in the midst of a flood or forest fire. Therefore, the body undergoes some change that allows it to counter its homeostatic need for sleep and to stay awake to avoid danger.
Turek and his team propose that this change in the sleep regulatory system is reflective of an allostatic response. In the short term, allostatic responses are adaptive, but when sustained on a chronic basis, such as in their study, an allostatic load will develop and lead to negative health outcomes. The allostatic load resulting from the accumulating sleep debt loops back to the sleep regulatory system itself and alters it.
"Even though animals and humans may be able to adapt their sleep system to deal with repeated sleep restriction conditions, there could be negative consequences when this pattern is maintained over a long period of time," said Turek. "This brings us back to the idea that repeated partial sleep restriction in humans has been linked to metabolic dysfunction and cardiovascular disease."
"Our lab is very interested in the interactions between sleep loss and metabolic function," said Aaron D. Laposky, research assistant professor at the Center for Sleep and Circadian Biology and an author of the paper. "As Americans have been getting less sleep per night, there has been a parallel trend for body mass index to significantly increase. We believe that when partial sleep loss occurs repeatedly over a long period of time, individuals are predisposed to alterations in the function of many physiological systems."
In addition to Laposky and Turek, other authors of the PNAS paper, titled "Repeated sleep restriction in rats leads to homeostatic and allostatic responses during recovery sleep," are graduate student Youngsoo Kim (lead author) and visiting scholar Bernard M. Bergmann, both from Northwestern.
Note: This story has been adapted from a news release issued by Northwestern University.

(taken from www.sciencedaily.com)

Melatonin Most Effective For Sleep When Taken For Off-hour Sleeping

Researchers from the Divisions of Sleep Medicine at Brigham and Women’s Hospital and Harvard Medical School have found in a double-blind placebo-controlled clinical study, that melatonin, taken orally during non-typical sleep times, significantly improves an individual’s ability to sleep.

This finding is particularly important for rotating or night-shift workers, travelers with jet lag and individuals with advanced or delayed sleep phase syndrome.
The findings appear in the May 1, 2006 issue of the journal Sleep.
Melatonin is a hormone produced by the body at night in darkness, which helps the brain determine day and night to help regulate sleep cycles and circadian timing. Retinal light exposure inhibits the release of the hormone.
Millions of Americans take melatonin supplements to improve their sleep, yet the results of prior studies on the efficacy of melatonin as a sleep-promoting agent have been mixed, according to the Agency of Healthcare Research and Quality, which carried out an extensive review of this topic two years ago. The present study, conducted at the Brigham and Women’s Hospital, sought to address this question.
Thirty-six participants (21 men and 15 women), between the ages of 18 and 30 with no significant past or current medical disorders, sleep disorders, or psychological disorders were chosen for the study from a pool of applicants.
The participants refrained from alcohol, caffeine, nicotine, illicit substances and prescription and non-prescription medications for three weeks prior to the start of the study. They were studied in sound-proof suites free of time clues. Participants were first studied for three days and nights in the lab on their traditional sleep schedules to measure their normal sleep structure and melatonin production.
“Participants were then kept on a 20-hour sleep-wake schedule, simulating a traveler crossing four time zones eastward every day,” explained Dr. Charles Czeisler, Chief of the Division of Sleep Medicine at Brigham and Women’s Hospital and senior author of the study. “For the next three weeks, thirty minutes before each sleep episode, participants ingested either a placebo, 0.3milligrams (mg), or 5.0mg of pharmaceutical grade melatonin.”
The researchers found that sleep efficiency during the six hour, 40 minute episodes was significantly higher in the groups that took melatonin during times when the body was not producing melatonin. At those times, participants taking 5.0mg of melatonin had a sleep efficiency of 83 percent and those taking 0.3mg melatonin had a sleep efficiency of 84 percent.
Sleep efficiency in both of these groups was significantly greater than that in participants taking placebo, who had a sleep efficiency of 77 percent. There was no significant difference in sleep efficiency among all participants during times when melatonin was being produced in the body.
James K. Wyatt, Ph.D., lead author of the study, Diplomate, American Board of Sleep Medicine and now acting Co-Director of the Sleep Disorders Service and Research Center at Rush University Medical Center in Chicago stated, “A landmark feature of this comprehensive research was the study of 24 successive sleep episodes in the same participants, including over 1,000 sleep recordings, across a full range if circadian phases – the body’s internal 24-hour timing system. We were able to definitively show in these healthy young adults that the use of melatonin as a sleep-aid was only beneficial for sleeping when the body wasn’t already releasing its own supply of melatonin.”
“These data leave little doubt about the effectiveness of melatonin in alleviating sleep disturbances when attempting to sleep at the wrong time of day, at least under laboratory conditions,” continued co-author Derk-Jan Dijk, now Director of the Surrey Sleep Research Centre, Surrey, England.
Czeisler concluded: “Melatonin enabled these participants to obtain an extra half hour of sleep when they attempted to do so during the day, at a time when they were not producing melatonin themselves. Melatonin did not help these young adults sleep at night, when their body was already producing melatonin. These finding have implications for millions of people who attempt to sleep at a time that is out of synch with the brain’s internal clock.”
The research was supported by the National Institute on Aging, the National Institutes of Health and the National Aeronautics and Space Administration.
Note: This story has been adapted from a news release issued by Rush University Medical Center.

(taken from www.sciencedaily.com)

Deviated septum surgery for sleep apnea

A deviated septum surgery is usually performed in cases of Obstruction of the nose and it has been found that nasal breathing is a common finding in patients with obstructive sleep apnea. And the cause of such obstruction may be due to turbinate tissue overgrowth, deviated septum or collapse/narrowing of the nasal valve.

The only way to correct a deviated septum is through surgery. Such a surgery namely septoplasty is usually performed on an out-patient basis, with either general or local anesthesia, and usually takes 1-1 1/2 hours. Such a procedure is performed entirely through the nostrils, and if it is the only procedure performed, it does not cause any bruising or swelling following surgery.
What Is a Deviated Septum surgery and how it occurs?
The nasal cavity is divided into two halves by a partition made of cartilage and bone, called the nasal septum. The two halves are the nostrils. But in as many as 80% of all people, the nasal cavity is not divided equally. This will result into a deviated septum. For many people, this imperfection does not cause any problems, but for some, it can lead to difficulty in breathing and even chronic sinus infections.
No nasal septum surgery is required for most people but in severe cases, surgery for deviated septum may be recommended.
It occurs when the septum is deviated at birth (congenital) or because of injury, such as a broken nose.
As stated above,the most used surgical method for nasal reconstruction in deviated septums is called Septoplasty. Done through the nose, this type of nasal reconstruction is done without incisions on the outside unless rhinoplasty is involved. And once the pieces of the septum are removed and straightened, they are then put back inside the nose.
After the surgery your nose is gonna drip blood--quite a bit of it in the first few hours after the surgery -but it will gradually reduce as more time passes.
Are there any alternatives for a deviated septum surgery ?
There are decongestants and antihistamines to combat allergic rhinitis (hay fever), which is often present as well systemic corticosteroids, e.g. Nasonex or prednisone.
There is not usually significant discomfort but there may be minor postoperative pain with septoplasty surgery, though . A short course of narcotic pain relievers is typically sufficient for pain relief. This surgery will be performed by one of our highly-trained specialists in the field.
Concerning the price for such an intervention the Cost depends upon complexity of procedure.
Many insurance companies will cover septoplasty, as it is a procedure which improves breathing function.
Once a deviated septum surgery has been completed, most people have clear nasal passages, less sinus infection, and unsightly bumps removed from their noses.
How to help prevent a deviated symptom?
So to help prevent a deviated septum:
1. Wear seat belts in airplanes automobiles and
2. Wear appropriate protective headgear when playing sports.
A deviated septum surgery is important for people suffering from blocked nose as this will greatly help alleviate the symptoms of sleep apnea.

(taken from www.sleepapneacuresnow.com)

Sleep Apnea

Do you choke or gasp during your sleep to get air into your lungs? Is your bed partner complaining about your loud and frequent snoring and frequent body movement that will force him or her to a separate bed or room.

Do you wake up in the morning with sore throat, your mouth is dry and you suffer from headache?

Do you fall asleep easily during the day or even have memory loss, poor judgment or even short attention span in whatever you do at home or at the office?

If you feel that you are experiencing any or some of the symptoms then my friend I'm afraid to say that you have sleep apnea.Before looking for the right sleep apnea cures you have to take into consideration the degree of severity: mild,moderate or severe, will depend on the Apnea Hypopnea Index (AHI). The AHI describes the number of respiratory arrests and periods of clearly diminished respiratory lows accompanied by oxygen decreases per hour. For instance: 20 apnea and 10 hypopnea equal an AHI of 30.

So what is this sleep apnea thing?How is it different from insomnia.

Sleep amnea is a sleep disorder meaning complete cessation of breathing. It occurs during sleep as a result of repetitive episodes of upper airway obstruction, usually associated with a reduction in blood oxygen saturation.

More than 18 millions of American women and men of all age groups are affected by such disorder.

It is as common as adult diabetes and is a serious and life threatening condition. So throughout this website we at sleepapneacuresnow.com have researched the web for up-to-date information, effective treatment and news about what is effective today. We would be happy if you find something here may it be advice,cure, news, recommendations or even products that may help you get relief from this sleeping disorder.

Continue..

(taken from www.sleepapneacuresnow.com)

New Result Research About Smoking

Researchers have known that secondhand smoke can be just as dangerous for nonsmokers as smoking is for smokers, but now there's fresh evidence quantifying just how hazardous the after burn from cigarettes can be, and how quickly it affects your body. Scientists at the Oregon Department of Health documented for the first time an hourly buildup of a cancer-causing compound from cigarette smoke in the blood and urine of nonsmokers working in bars and restaurants in the state.

Reporting in the American Journal of Public Health, the researchers found that waitstaff and bartenders working a typical night shift gradually accumulated higher levels of NNK, a carcinogen in cigarette smoke, at the rate of 6% each hour they worked. NNK is known to be involved in inducing lung cancer in both lab rats and smokers.

"We were somewhat surprised by the immediacy of the effect and the fact that we could measure the average hourly increase," says Michael Stark, the lead author of the study and a principal investigator at the Mulmomah County Health Department in Oregon.

Previous studies conducted in homes where one family member smoked, or in work environments where some employees lit up, had found that nonsmokers in these environments on average increased their risk of developing lung cancer, as well as other health conditions such as heart disease and respiratory ailments, by 20%. And the Surgeon General, in a comprehensive report last year on the health effects of secondhand smoke, determined that there is "no risk-free level of exposure to secondhand smoke." But until now, it wasn't clear how quickly the carcinogens became absorbed.

The authors are confident that the increases in NNK in the workers they tested most likely came from their exposure to smoke — the study included a control group of similar subjects in restaurants where no smoking was allowed, and these workers showed no differences in the amount of NNK in their urine before and after their shifts.

The findings only underscore what public health officials have been arguing for decades — that cordoning off smokers in indoor environments or relying on ventilation systems in restaurants and bars is not enough. "There is experimental evidence from studies where you put nonsmokers in a room, blow smoke into the room and measure their artery function, that you see the platelets get sticky, which can cause clots and lead to a heart attack, and the ability of the arteries to dilate decreases very rapidly," says Dr. Matthew McKenna, director of the office on smoking and public health for the Centers for Disease Control.

All of which could mean more time loitering outside buildings and in alleyways for smokers intent on grabbing a puff. Thirteen states now prohibit smoking in restaurants altogether (most of these include bars as well), and while 11 states still put no restrictions on lighting up, individual cities within those states — such as Austin in Texas, for example — have passed legislation banning smoking in eating establishments and other public areas. Many of these regulations are the direct result of grassroots advocacy efforts; "It's been a very effective strategy," says McKenna." If the discussion moves to a centralized place like the state legislatures, opponents can concentrate their efforts and water down the argument for a ban. But if there are 40 municipalities working on smoking bans at the same time, it's difficult for opponents to fight so many battles at the same time."

More states are also passing laws to override a loophole — known as a pre-emption — that prevents cities and local municipalities from passing more restrictive laws than the state. It's just getting harder to refute the scientific evidence; in a study done in Scotland several months after that nation instituted a ban on smoking in public places, researchers found that following the ban, bar patrons showed stronger lung capacity and reduced levels of inflammation (a red flag for a number of chronic diseases, including heart disease and asthma). "We made it pretty clear that the science on this is pretty irrefutable," says McKenna. And if smokers have fewer places to smoke, that message may finally get heard.

(from time.com)